Elastic Abdominal Binders Attenuate Orthostatic Hypotension in Parkinson's Disease

Abstract

Background and methods: To investigate the possible efficacy of an elastic abdominal binder to control orthostatic hypotension (OH) associated with Parkinson's disease (PD), 15 patients with PD and OH were enrolled in a single-blind crossover study with elastic abdominal versus placebo binder on two different days, separated by a 1-day interval, followed by a 4-week open-label follow-up.

Results: Intervention significantly reduced blood pressure fall upon tilting. The mean difference (standard deviation; 95% confidence intervals) between abdominal binder versus placebo was +10 mm Hg (10.2; +3.5, +16.5; P = 0.006). No significant effect on supine mean blood pressure values was observed compared to placebo (P = 0.3). Symptoms of OH decreased significantly during follow-up (P = 0.003), as assessed by means of the Orthostatic Hypotension Questionnaire.

Conclusions: Our findings suggest that elastic abdominal binders may be a simple complementary tool to alleviate OH in PD.

Keywords: Orthostatic Hypotension Questionnaire (OHQ); Parkinson's disease; abdominal binder; orthostatic hypotension.

Figures

Figure 1

Study flow chart. Clinical demographic characteristics of the 12 patients included in the primary outcome analysis: 8 men; 69 years old (66; 75); disease duration 6 years (3; 12); H & Y stage 2 (2; 2,5); levodopa equivalent dose 555 mg/day (228; 1,690); use of antihypertensive medications n = 6; use of compression stockings n = 2; use of antihypotensive medications n = 2; MDS‐UPDRS total score = 54 (41; 66); MDS‐UPDRS part I = 12 (8; 18); item 12 (cardiovascular) of MDS‐UPDRS part I = 2.5 (1; 3); MDS‐UPDRS part II = 13 (9; 15); MDS‐UPDRS part III = 29 (19, 36); NMSS total score = 81 (50; 106); NMSS cardiovascular subscore = 8 (4; 8); SCOPA‐AUT total score = 21 (14; 29); SCOPA‐AUT cardiovascular subscore = 4 (2; 6). Quantitative variables are reported as median (1st quartile; 3rd quartile). NSAIDs, nonsteroidal anti‐inflammatory drugs.